NURS 121L-A | Introduction to Medical-Surgical Nursing Practicum |
Week 7 Quiz 2026 |WCU
1. A patient who underwent a total hip replacement 24 hours ago reports
sudden chest pain and shortness of breath. Which action should the nurse take
first?
A. Obtain an 12-lead electrocardiogram
B. Administer the prescribed PRN morphine
C. Apply high-flow oxygen via non-rebreather mask
D. Assess the surgical site for bleeding
Answer: C
Rationale: Sudden chest pain and dyspnea post-orthopedic surgery are classic signs of a
pulmonary embolism. The priority is to stabilize oxygenation.
2. When assessing a patient with a potassium level of 2.8 mEq/L, which finding
is most concerning to the nurse?
A. Presence of U-waves on the ECG monitor
B. Muscle weakness in the lower extremities
C. Hypoactive bowel sounds
D. Decreased deep tendon reflexes
Answer: A
Rationale: Hypokalemia can cause life-threatening cardiac dysrhythmias; U-waves are a
specific indicator of significant low potassium.
,3. The nurse is caring for a patient with a Stage III pressure injury. Which
characteristic should the nurse expect to observe?
A. Non-blanchable erythema of intact skin
B. Partial-thickness loss of dermis with a shallow open ulcer
C. Full-thickness tissue loss with visible subcutaneous fat
D. Full-thickness tissue loss with exposed bone or tendon
Answer: C
Rationale: Stage III involves full-thickness skin loss involving damage to or necrosis of
subcutaneous tissue that may extend down to, but not through, underlying fascia.
4. A patient is receiving a blood transfusion and begins to experience chills,
fever, and lower back pain. What is the nurse’s priority action?
A. Slow the infusion rate and call the provider
B. Administer diphenhydramine as ordered
C. Stop the infusion and disconnect the tubing at the hub
D. Check the patient’s vital signs and re-verify the blood bag
Answer: C
Rationale: These are symptoms of an acute hemolytic reaction. The infusion must be
stopped immediately to prevent further damage.
5. Which assessment finding in a patient with Chronic Obstructive Pulmonary
Disease (COPD) requires immediate intervention?
A. Oxygen saturation of 89% on room air
B. Barrel-shaped chest and use of accessory muscles
C. Presence of a productive cough with clear sputum
D. New onset of confusion and lethargy
Answer: D
Rationale: Confusion and lethargy in a COPD patient can indicate CO2 narcosis or severe
hypoxemia, signaling respiratory failure.
, 6. A nurse is preparing to administer NPH insulin at 0730. When should the
nurse be most alert for signs of hypoglycemia?
A. Between 1100 and 1500
B. Between 0800 and 0930
C. Between 1700 and 2100
D. Between 2300 and 0100
Answer: A
Rationale: NPH is an intermediate-acting insulin with a peak effect occurring 4 to 12 hours
after administration.
7. What is the most effective nursing intervention to prevent atelectasis in a
postoperative patient?
A. Administering prophylactic antibiotics
B. Maintaining the patient in a supine position
C. Encouraging the use of an incentive spirometer every hour
D. Restricting fluid intake to 1000 mL per day
Answer: C
Rationale: Incentive spirometry promotes deep breathing and lung expansion, preventing
the collapse of alveoli (atelectasis).
8. A patient with a history of heart failure reports a weight gain of 3 lbs (1.4 kg)
over the last 24 hours. Which assessment should the nurse perform first?
A. Check for peripheral edema in the lower extremities
B. Assess for jugular venous distention
C. Measure the patient’s abdominal girth
D. Auscultate the lungs for crackles
Answer: D
Rationale: Rapid weight gain in heart failure suggests fluid volume excess. Lung
auscultation is the priority to detect pulmonary edema.
Week 7 Quiz 2026 |WCU
1. A patient who underwent a total hip replacement 24 hours ago reports
sudden chest pain and shortness of breath. Which action should the nurse take
first?
A. Obtain an 12-lead electrocardiogram
B. Administer the prescribed PRN morphine
C. Apply high-flow oxygen via non-rebreather mask
D. Assess the surgical site for bleeding
Answer: C
Rationale: Sudden chest pain and dyspnea post-orthopedic surgery are classic signs of a
pulmonary embolism. The priority is to stabilize oxygenation.
2. When assessing a patient with a potassium level of 2.8 mEq/L, which finding
is most concerning to the nurse?
A. Presence of U-waves on the ECG monitor
B. Muscle weakness in the lower extremities
C. Hypoactive bowel sounds
D. Decreased deep tendon reflexes
Answer: A
Rationale: Hypokalemia can cause life-threatening cardiac dysrhythmias; U-waves are a
specific indicator of significant low potassium.
,3. The nurse is caring for a patient with a Stage III pressure injury. Which
characteristic should the nurse expect to observe?
A. Non-blanchable erythema of intact skin
B. Partial-thickness loss of dermis with a shallow open ulcer
C. Full-thickness tissue loss with visible subcutaneous fat
D. Full-thickness tissue loss with exposed bone or tendon
Answer: C
Rationale: Stage III involves full-thickness skin loss involving damage to or necrosis of
subcutaneous tissue that may extend down to, but not through, underlying fascia.
4. A patient is receiving a blood transfusion and begins to experience chills,
fever, and lower back pain. What is the nurse’s priority action?
A. Slow the infusion rate and call the provider
B. Administer diphenhydramine as ordered
C. Stop the infusion and disconnect the tubing at the hub
D. Check the patient’s vital signs and re-verify the blood bag
Answer: C
Rationale: These are symptoms of an acute hemolytic reaction. The infusion must be
stopped immediately to prevent further damage.
5. Which assessment finding in a patient with Chronic Obstructive Pulmonary
Disease (COPD) requires immediate intervention?
A. Oxygen saturation of 89% on room air
B. Barrel-shaped chest and use of accessory muscles
C. Presence of a productive cough with clear sputum
D. New onset of confusion and lethargy
Answer: D
Rationale: Confusion and lethargy in a COPD patient can indicate CO2 narcosis or severe
hypoxemia, signaling respiratory failure.
, 6. A nurse is preparing to administer NPH insulin at 0730. When should the
nurse be most alert for signs of hypoglycemia?
A. Between 1100 and 1500
B. Between 0800 and 0930
C. Between 1700 and 2100
D. Between 2300 and 0100
Answer: A
Rationale: NPH is an intermediate-acting insulin with a peak effect occurring 4 to 12 hours
after administration.
7. What is the most effective nursing intervention to prevent atelectasis in a
postoperative patient?
A. Administering prophylactic antibiotics
B. Maintaining the patient in a supine position
C. Encouraging the use of an incentive spirometer every hour
D. Restricting fluid intake to 1000 mL per day
Answer: C
Rationale: Incentive spirometry promotes deep breathing and lung expansion, preventing
the collapse of alveoli (atelectasis).
8. A patient with a history of heart failure reports a weight gain of 3 lbs (1.4 kg)
over the last 24 hours. Which assessment should the nurse perform first?
A. Check for peripheral edema in the lower extremities
B. Assess for jugular venous distention
C. Measure the patient’s abdominal girth
D. Auscultate the lungs for crackles
Answer: D
Rationale: Rapid weight gain in heart failure suggests fluid volume excess. Lung
auscultation is the priority to detect pulmonary edema.
